Cognitive Rehabilitation in Parkinson’s Disease: A systematic review

Introduction: Cognitive impairments are the most common non-motor symptoms in Parkinson’s Disease (PD). These symptoms have a negative impact on patients’ quality of life and daily living activities. This review will focus on published articles that investigated the efficacy of cognitive rehabilitation in PD. Objectives: To review the existing literature on the efficacy of cognitive rehabilitation in PD and highlight the most effective form of intervention to prevent cognitive decline. This review will also point out any limitations and provide directions for future research. Methods: Published articles available in the Web of Science and PubMed databases up to November 2017 were reviewed for possible inclusion. We identified 15 articles that examined the effects of cognitive rehabilitation in PD and met inclusion criteria. Results: The main outcomes of this review indicated that, although previous studies used different cognitive rehabilitation methodologies, all studies reported cognitive improvements on at least one cognitive domain. Additionally, the most frequent cognitive domains showing improvements are executive functions and attention. Conclusion: This review reports the outcomes of studies that examined the effectiveness of cognitive rehabilitation in PD. It also points out the limitations of the studies indicating the limited availability of follow up data on the long-term effects of cognitive interventions. The review also highlights the fact that some of the studies did not include a PD group who did not undergo training. There remains, therefore, a need for longitudinal studies to investigate the potential long term benefits of cognitive training. In addition, future investigations should examine whether any disease characteristics such as disease stage, degree of cognitive impairment and/or the dominant side (right/left) or specific motor symptoms (rigidity/tremor) influence treatment efficacy